الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Internalized (or self) stigma refers to the incorporation of other’s prejudices and stereotypes about people into beliefs about oneself with mental illness which results from applying a socially negative stereotype to one-self. . It further leads to many people with schizophrenia experienced significant negative effect such as reduced self-esteem, empowerment, hope, and sense of recovery, as well as exacerbated psychiatric symptoms and greater reluctance to engage in treatment and hindering social relationships and support.
So the interest in study the nature of this internalized stigma its relationship with self-esteem, hope and social support among patients with schizophrenia will help in understanding it well and enlighten the way for dealing with it.
Setting:
The study was conducted at the outpatient clinics of El-Maamoura Hospital for Psychiatric Medicine.
Subjects:
The study covered 150 patients with schizophrenia with no comorbidity
Both sex
Aged between 20 to 60years,
Able to communicate and who agreed to participate in the study.
Tools of data collection:
Tool I:
Part 1: Socio-demographic and clinical data structured interview schedule: (Appendix I)
It was developed by the researcher to elicit data about the patient’s socio-demographic data as age, sex, marital status, educational level, employment and residence. The patient’s clinical data as, duration of illness, age of onset of illness, number of previous psychiatric hospitalization, medication presently prescribed for patient .
Part 2: Internalized stigma of mental illness (ISMI) (Appendix I):
Internalized Stigma of Mental Illness (ISMI) scalewas developed by Ritsher et al (2003) (8). It was used to measure the nature of internalized Stigma of Mental Illness among persons with schizophrenia. It is a self -report scale and consists of 29 items divided into five subscales categorized as alienation, stereotype endorsement, social withdrawal, perceived discrimination and stigma-resistance. The items have to be rated on a four-point-Likert scale
Tool II: Rosenberg Self-Esteem Scale(RSE)(Appendix II):
Rosenberg Self-Esteem Scale (RSE) was developed by Rosenberg (1965) (26). It was used to measure global self-esteem .The tool was translated into Arabic by Al Bakoor (2008) (27). It is a self- report scale composed of 10 items that measures overall feeling of self- worth or self- acceptance. Items are responded on a four point Likert scale.
Tool III: State Hope Scale (SHS)( Appendix III):
State Hope Scale (SHS) was developed by Snyder et al (1991) (28). It was used to measure an individual’s hope. It also called goal directed scale. It is a self- report scale consisted of 8 items divided into two subscales: four items for each the pathways subscale and the agency subscale.It is rated on 8-point Likert scale.
Tool IV: The personal Resource Questionnaire (PRQ-2000) ( Appendix ( Appendix ( Appendix ( Appendix IV):IV):IV):
The personal Resource Questionnaire (PRQ-2000)was developed by Brandt & Weinert (1981) and modified byWeinert (2003) (31, 32). It was used to measure perceived social support. It is a self – administered instrument consisted of 15 items on a 7- point Likert scale.
Methods for actual study
A jury composed of 5 experts of psychiatric and mental health nursing had examined the content validity of tools and modifications were done accordingly and revealed that the tools are valid. Reliability of translated tools I, II, III and IV were tested on 30 inpatients with schizophrenia using Cronbach’s alpha test. The tools proved to be reliable, (r=.840, r=.671, r=.759 and r=.893) respectively. A pilot study was carried out on 20 patients with schizophrenia who meet the inclusion criteria of the study sample to test the applicability of the tools and to identify obstacles that may be faced during data collection. The result of pilot study revealed that tools III (State Hope Scale&,) was too difficult for the patient to choose the response from 1 to 8 the patients reported having confusion so the tool was modified statistically to be from 1 to 4 as well as tool IV (Personal Resource Questionnaire 2000) was modified from 1 to 7 to 1 to 5 after consulting statistics. Written and oral consent were obtained from all patients. Patients were interviewed on an individual basis for about 45-60 minutes. Patients included in the study were informed about the aim of the study and were ensured about the confidentiality of their data. The data were collected over a period of four months, starting from April 2016 to August 2016.
The data were computerized and verified using the SPSS (Statistical Package for Social Science) version 20.0 to perform tabulation and statistical analysis.
Recommendations geared towardfurther researches
4- Assess impact of internalized stigma on quality life among patients with schizophrenia.
5- The present results need to be replicated at various time points and on larger sample to understand the nature of the relationships.
6- Further researches are needed to focus on internalized stigma and its correlates as potential barriers to recovery from schizophrenia.